Hilmi Erdem Sumbul1, Ayse Selcan Koc2, Derya Demirtas3, Hasan Koca4, Burcak Cakir Pekoz2, Feride Fatma Gorgulu2, Yurdaer Donmez4, Abdullah Orhan Demirtas4, Mevlut Koc4, Yahya Kemal Icen4. 1. Department of Internal Medicine, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey. erdemsumbul@gmail.com. 2. Department of Radiology, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey. 3. Department of Internal Medicine, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey. 4. Department of Cardiology, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey.
Abstract
PURPOSE: We aimed to investigate the relation between renal cortical stiffness (CS) obtained by shear-wave elastography (SWE) and contrast-induced nephropathy (CIN) development in interventional treatment-planned acute coronary syndrome (ACS) patients. METHODS: Our study group consisted of 465 ACS patients. Routine laboratory assessments, B-mode, Doppler, and SWE renal ultrasonography (USG) evaluations were performed. Renal resistive index (RRI), renal pulsatility index (RPI), and acceleration time (AT) and CS were measured. Patients were grouped as with and without CIN. RESULTS: Among the study group, 55 patients (11.8%) had CIN. Age, diabetes mellitus (DM), hypertension (HT), basal creatinine, CK-MB and troponin I levels, contrast volume, contrast volume/weight ratio, SYNTAX score, RRI, RPI, AT, and CS values were significantly higher in patients with CIN. eGFR was lower in patients who developed CIN. Age, contrast volume/weight ratio, and CS were determined as independent predictors of CIN occurrence in logistic regression analysis. In multivariate logistic analysis, increase of age (each year), contrast volume/weight (each 0.2 mL/kg), and CS (each 1 kPa) were found to augment the development of CIN by 7.1, 59.5, and 62.3%, respectively. In the ROC analysis, CS had the highest AUROC value. The cutoff value of CS obtained by the ROC curve analysis was 7 kPa for the CIN development (sensitivity: 74.5%, specificity: 72.5%). CONCLUSION: CS value is a simple, cheap, reproducible, noninvasive, and objective parameter for the detection of CIN development. ACS patients should be directed to renal USG, and routine CS value should be written besides USG measurements in reports.
PURPOSE: We aimed to investigate the relation between renal cortical stiffness (CS) obtained by shear-wave elastography (SWE) and contrast-induced nephropathy (CIN) development in interventional treatment-planned acute coronary syndrome (ACS) patients. METHODS: Our study group consisted of 465 ACS patients. Routine laboratory assessments, B-mode, Doppler, and SWE renal ultrasonography (USG) evaluations were performed. Renal resistive index (RRI), renal pulsatility index (RPI), and acceleration time (AT) and CS were measured. Patients were grouped as with and without CIN. RESULTS: Among the study group, 55 patients (11.8%) had CIN. Age, diabetes mellitus (DM), hypertension (HT), basal creatinine, CK-MB and troponin I levels, contrast volume, contrast volume/weight ratio, SYNTAX score, RRI, RPI, AT, and CS values were significantly higher in patients with CIN. eGFR was lower in patients who developed CIN. Age, contrast volume/weight ratio, and CS were determined as independent predictors of CIN occurrence in logistic regression analysis. In multivariate logistic analysis, increase of age (each year), contrast volume/weight (each 0.2 mL/kg), and CS (each 1 kPa) were found to augment the development of CIN by 7.1, 59.5, and 62.3%, respectively. In the ROC analysis, CS had the highest AUROC value. The cutoff value of CS obtained by the ROC curve analysis was 7 kPa for the CIN development (sensitivity: 74.5%, specificity: 72.5%). CONCLUSION:CS value is a simple, cheap, reproducible, noninvasive, and objective parameter for the detection of CIN development. ACS patients should be directed to renal USG, and routine CS value should be written besides USG measurements in reports.
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